Even as Southasians watched in disbelief the crossborder chase of Amit Kumar, the disgraced transplant doctor, as he fled from his Gurgaon office to the Chitwan jungles of southern Nepal (and, allegedly, planned to move on surreptitiously to Canada), the people of Pakistan have breathed something of a collective sigh of relief. It is a sigh that still holds some trepidation, however. After decades of deliberation, and having long been a centre of illegal transplants of kidneys and other organs, in late 2007 Pakistani legislators won wide approval for finally promulgating a law regulating the transplants of human organs and tissues. The "Transplantation of Human Organs and Human Tissue Ordinance" now prescribes punishments of up to 10 years imprisonment and fines of PKR 1 million (USD 15,900) for those dealing 'unlawfully' in organs, and those who remove these organs without the victim's consent.
Perhaps most importantly, the new ordinance explicitly bans the 'donation' of organs to foreigners, clearly the most well-to-do of clients throughout the region. At Dr Kumar's Gurgaon office, for instance, a kidney transplant used to cost up to USD 2500; when he was arrested by Nepali security forces, the doctor was found with packets of money worth about USD 150,000. For transplant services in Pakistan, foreign clients generally came from the US, Europe and West Asia, thronging the country largely due to lax or non-existent regulatory control. (Pakistan and Bangladesh had long been the only two countries in Asia without any organ-transplant legislation.) Arab patients to Pakistan generally numbered the highest, partially due to the wealth on the peninsula, and partially due to the fact that the Islamabad government had given them special treatment as 'close friends' of the state.
The 2007 ordinance gained particular praise for allowing 'cadaver transplantation', or the transplantation of organs from those who had been declared brain dead, if they had indicated their approval of such a procedure while alive. This was a major break with older legislation, as for decades the only legal transplantation in Pakistan had been from living donors. This had not only dramatically reduced the number of transplant possibilities for Pakistanis themselves, but hiked up the costs.
Ghoulishly, pre-existing legal stipulation had also led to the creation of a thriving underground trade in 'living organs'. Oftentimes these came from poor labourers hoping to settle debts, though stories continue to circulate of people being drugged and outright 'robbed' of their organs. At one point, an estimated 2000 kidneys were being transplanted every year in Pakistan; and, in what was described as a flourishing 'kidney tourism', half of those were for patients from outside of the country. The World Health Organisation said that an average of around 1500 tourists were coming to Pakistan every year for transplants of various kinds, though others have placed that number significantly higher.